ArticleAmerican journal of otolaryngology
A prospective cohort study testing whether oral cavity mucosal tissue variability influences elastic scattering spectroscopy (ESS) measures.
Article in American journal of otolaryngology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveElastic Scattering Spectroscopy (ESS) has been shown to accurately discriminate between benign and malignant tissue in the oral cavity, which makes it a promising technology to assist with intraoperative oral cancer margin guidance. However, some spectroscopy-based technologies are influenced by locoregional histopathological differences, which can influence diagnostic accuracy and data acquisition procedures. The objective of this study was to assess the extent to which ESS spectral readings of mucosal tissue varied between different anatomic regions of the oral cavity in a cohort of healthy adults.
methodsThe study included 30 participants with no known history of smoking, vaping, or other substance use-related carcinogenic exposures, with normal oral mucosa, and without history of head or neck cancer or other inflammatory conditions. ESS measurements were obtained at predefined anatomic sites within the oral cavity, and spectra were grouped into five classes based on histopathologic similarities of tissue architecture (Class 1: soft palate, mucosal lip, buccal mucosa; Class 2: retromolar trigone, hard palate, gingiva; Class 3: dorsal tongue; Class 4: lateral tongue; Class 5: floor of mouth, ventral tongue). Random forests were used to build predictive models and Leave-One-Patient-Out (LOPO) cross-validation used to obtain performance statistics. Statistical analyses included sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and overall model accuracy.
resultsOverall analysis yielded sensitivity = 52.2%, specificity = 88.4%, and accuracy = 0.52. The overall mean weighted F1 score was 0.53. Using a one-vs-all approach of the five anatomic sites, sensitivity = 43.4%-62.1%, specificity = 85%-91%, PPV = 29.2%-61.5%, and NPV = 78.3%-95.5%.
conclusionDiscriminatory accuracy between pairs of oral cavity subsites was moderate, but still significantly above random chance (0.20 for five classes). This supports the contention that the success of ESS in identifying malignancy is robust against locoregional variations in "normal" tissues within the oral cavity. These data further support the application of ESS as a valuable adjunct tool for oral cancer margin guidance by demonstrating that ESS is tissue agnostic in the oral cavity.
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